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Prevalence, Risk Factors, and Treatment Outcomes of Isoniazid- and Rifampicin-Mono-Resistant Pulmonary Tuberculosis in Lima, Peru

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dc.contributor.author Villegas, Leonela
dc.contributor.author Otero Vegas, Larissa
dc.contributor.author Sterling, Timothy-R.
dc.contributor.author Huaman, Moises-A.
dc.contributor.author Van-der-Stuyft, Patrick
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Seas Ramos, Carlos Rafael
dc.date.accessioned 2019-02-06T14:48:07Z
dc.date.available 2019-02-06T14:48:07Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5177
dc.description.abstract BACKGROUND: Isoniazid and rifampicin are the two most efficacious first-line agents for tuberculosis (TB) treatment. We assessed the prevalence of isoniazid and rifampicin mono-resistance, associated risk factors, and the association of mono-resistance on treatment outcomes. METHODS: A prospective, observational cohort study enrolled adults with a first episode of smear-positive pulmonary TB from 34 health facilities in a northern district of Lima, Peru, from March 2010 through December 2011. Participants were interviewed and a sputum sample was cultured on Lowenstein-Jensen (LJ) media. Drug susceptibility testing was performed using the proportion method. Medication regimens were documented for each patient. Our primary outcomes were treatment outcome at the end of treatment. The secondary outcome included recurrent episodes among cured patients within two years after completion of the treatment. RESULTS: Of 1292 patients enrolled, 1039 (80%) were culture-positive. From this subpopulation, isoniazid mono-resistance was present in 85 (8%) patients and rifampicin mono-resistance was present in 24 (2%) patients. In the multivariate logistic regression model, isoniazid mono-resistance was associated with illicit drug use (adjusted odds ratio (aOR) = 2.10; 95% confidence interval (CI): 1.1-4.1), and rifampicin mono-resistance was associated with HIV infection (aOR = 9.43; 95%CI: 1.9-47.8). Isoniazid mono-resistant patients had a higher risk of poor treatment outcomes including treatment failure (2/85, 2%, p-value<0.01) and death (4/85, 5%, p<0.02). Rifampicin mono-resistant patients had a higher risk of death (2/24, 8%, p<0.01). CONCLUSION: A high prevalence of isoniazid and rifampicin mono-resistance was found among TB patients in our low HIV burden setting which were similar to regions with high HIV burden. Patients with isoniazid and rifampicin mono-resistance had an increased risk of poor treatment outcomes. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Antitubercular Agents/therapeutic use en_US
dc.subject Drug Resistance, Bacterial en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Isoniazid/therapeutic use en_US
dc.subject Male en_US
dc.subject Peru/epidemiology en_US
dc.subject Prevalence en_US
dc.subject Rifampin/therapeutic use en_US
dc.subject Risk Factors en_US
dc.subject Tuberculosis, Pulmonary/drug therapy/epidemiology en_US
dc.title Prevalence, Risk Factors, and Treatment Outcomes of Isoniazid- and Rifampicin-Mono-Resistant Pulmonary Tuberculosis in Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0152933
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.05
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.07
dc.relation.issn 1932-6203

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